Deformities Influencing Different Classes in Progressive Collapsing Foot

Category: Midfoot/Forefoot; Hindfoot Introduction/Purpose: The current classification system of progressive collapsing foot deformity (PCFD) is comprised of 5 possible classes. PCFD is understood to be a complex, three-dimensional deformity occurring in many regions along the foot and ankle. The que...

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Main Authors: Aly M. Fayed MD, MSc, Vineel Mallavarapu BS, Eli Schmidt, Ki Chun Kim, Matthieu Lalevee MD, PhD, Amanda Ehret, François Lintz MD, MS, Kepler A.M. Carvalho MD, Nacime Salomao Barbachan Mansur MD, PhD, Cesar de Cesar Netto MD, PhD
Format: Article
Language:English
Published: SAGE Publishing 2023-12-01
Series:Foot & Ankle Orthopaedics
Online Access:https://doi.org/10.1177/2473011423S00141
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author Aly M. Fayed MD, MSc
Vineel Mallavarapu BS
Eli Schmidt
Ki Chun Kim
Matthieu Lalevee MD, PhD
Amanda Ehret
François Lintz MD, MS
Kepler A.M. Carvalho MD
Nacime Salomao Barbachan Mansur MD, PhD
Cesar de Cesar Netto MD, PhD
author_facet Aly M. Fayed MD, MSc
Vineel Mallavarapu BS
Eli Schmidt
Ki Chun Kim
Matthieu Lalevee MD, PhD
Amanda Ehret
François Lintz MD, MS
Kepler A.M. Carvalho MD
Nacime Salomao Barbachan Mansur MD, PhD
Cesar de Cesar Netto MD, PhD
author_sort Aly M. Fayed MD, MSc
collection DOAJ
description Category: Midfoot/Forefoot; Hindfoot Introduction/Purpose: The current classification system of progressive collapsing foot deformity (PCFD) is comprised of 5 possible classes. PCFD is understood to be a complex, three-dimensional deformity occurring in many regions along the foot and ankle. The question remains whether a deformity in one area impacts other areas. The objective of this study is to assess how each one of the classes is influenced by other classes by evaluating each associated angular measurement. We hypothesized that positive and linear correlations would occur for each class with at least one other class and that this influence would be high. Methods: We retrospectively assessed weight-bearing computed tomography (WBCT) measurements of 32 feet with PCFD diagnosis. The classes and their associated radiographic measurements were defined as follows: class A (hindfoot valgus) measured by the hindfoot moment arm (HMA), class B (midfoot abduction) measured by the talonavicular coverage angle (TNCA), class C (medial column instability) measured by Meary’s angle, class D (peritalar subluxation) measured by the medial facet uncoverage (MFU), and class E (ankle valgus) measured using the talar tilt angle (TTA). Multivariate analyses were completed comparing each class measurement to the other classes. A p-value < 0.05 was considered significant. Results: Class A showed a substantial positive correlation with class C (ρ=0.71; R2=0.576; p 0.001). Class B was substantially correlated with class D (ρ=0.74; R2=0.613; p 0.001). Class C showed a substantial positive correlation with class A (ρ=0.71; R2=0.576; p 0.001) and class D (ρ=0.75; R2=0.559; p 0.001). Class D showed a substantial positive correlation with class B and class C (ρ=0.74; R2=0.613; p 0.001), (ρ=0.75; R2=0.559; p 0.001) respectively. Class E did not show correlation with class B, C, or D (ρ=0.24; R2=0.074; p=0.059), (ρ=0.17; R2=0.071; p=0.179), and (ρ=0.22; R2=0.022; p=0.082) respectively. The average values of each class radiographic markers are listed in Figure 1. Conclusion: This study was able to find relations between components of PCFD deformity with exception of ankle valgus deformity (Class E). Measurements associated with each class were influenced by others, and in some instances, with pronounced strength such as between class A and C as well as between Class B and D. Surgical procedures to address certain class deformities could indirectly address other classes as well, which ultimately decreases surgical procedures numbers or complexity. The presented data may support the notion that PCFD is a three-dimensional complex deformity and suggests a possible relation among its ostensibly independent features.
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spelling doaj.art-03e7747354204144acbe91bafdde4f262023-12-26T10:04:26ZengSAGE PublishingFoot & Ankle Orthopaedics2473-01142023-12-01810.1177/2473011423S00141Deformities Influencing Different Classes in Progressive Collapsing FootAly M. Fayed MD, MScVineel Mallavarapu BSEli SchmidtKi Chun KimMatthieu Lalevee MD, PhDAmanda EhretFrançois Lintz MD, MSKepler A.M. Carvalho MDNacime Salomao Barbachan Mansur MD, PhDCesar de Cesar Netto MD, PhDCategory: Midfoot/Forefoot; Hindfoot Introduction/Purpose: The current classification system of progressive collapsing foot deformity (PCFD) is comprised of 5 possible classes. PCFD is understood to be a complex, three-dimensional deformity occurring in many regions along the foot and ankle. The question remains whether a deformity in one area impacts other areas. The objective of this study is to assess how each one of the classes is influenced by other classes by evaluating each associated angular measurement. We hypothesized that positive and linear correlations would occur for each class with at least one other class and that this influence would be high. Methods: We retrospectively assessed weight-bearing computed tomography (WBCT) measurements of 32 feet with PCFD diagnosis. The classes and their associated radiographic measurements were defined as follows: class A (hindfoot valgus) measured by the hindfoot moment arm (HMA), class B (midfoot abduction) measured by the talonavicular coverage angle (TNCA), class C (medial column instability) measured by Meary’s angle, class D (peritalar subluxation) measured by the medial facet uncoverage (MFU), and class E (ankle valgus) measured using the talar tilt angle (TTA). Multivariate analyses were completed comparing each class measurement to the other classes. A p-value < 0.05 was considered significant. Results: Class A showed a substantial positive correlation with class C (ρ=0.71; R2=0.576; p 0.001). Class B was substantially correlated with class D (ρ=0.74; R2=0.613; p 0.001). Class C showed a substantial positive correlation with class A (ρ=0.71; R2=0.576; p 0.001) and class D (ρ=0.75; R2=0.559; p 0.001). Class D showed a substantial positive correlation with class B and class C (ρ=0.74; R2=0.613; p 0.001), (ρ=0.75; R2=0.559; p 0.001) respectively. Class E did not show correlation with class B, C, or D (ρ=0.24; R2=0.074; p=0.059), (ρ=0.17; R2=0.071; p=0.179), and (ρ=0.22; R2=0.022; p=0.082) respectively. The average values of each class radiographic markers are listed in Figure 1. Conclusion: This study was able to find relations between components of PCFD deformity with exception of ankle valgus deformity (Class E). Measurements associated with each class were influenced by others, and in some instances, with pronounced strength such as between class A and C as well as between Class B and D. Surgical procedures to address certain class deformities could indirectly address other classes as well, which ultimately decreases surgical procedures numbers or complexity. The presented data may support the notion that PCFD is a three-dimensional complex deformity and suggests a possible relation among its ostensibly independent features.https://doi.org/10.1177/2473011423S00141
spellingShingle Aly M. Fayed MD, MSc
Vineel Mallavarapu BS
Eli Schmidt
Ki Chun Kim
Matthieu Lalevee MD, PhD
Amanda Ehret
François Lintz MD, MS
Kepler A.M. Carvalho MD
Nacime Salomao Barbachan Mansur MD, PhD
Cesar de Cesar Netto MD, PhD
Deformities Influencing Different Classes in Progressive Collapsing Foot
Foot & Ankle Orthopaedics
title Deformities Influencing Different Classes in Progressive Collapsing Foot
title_full Deformities Influencing Different Classes in Progressive Collapsing Foot
title_fullStr Deformities Influencing Different Classes in Progressive Collapsing Foot
title_full_unstemmed Deformities Influencing Different Classes in Progressive Collapsing Foot
title_short Deformities Influencing Different Classes in Progressive Collapsing Foot
title_sort deformities influencing different classes in progressive collapsing foot
url https://doi.org/10.1177/2473011423S00141
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